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Writer's pictureAlex Steiner, LCSW

What to Expect with LGBTQIA+ Therapy


LGBTQ Pride Photoshoot. Photo by <a href="https://unsplash.com/@divya_agrawal?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText">Divya Agrawal</a> on <a href="https://unsplash.com/?utm_source=unsplash&utm_medium=referral&utm_content=creditCopyText">Unsplash</a>

The Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersexed, Asexual (LGBTQIA*) community represents a diverse range and umbrella of identities and expression of gender and sexual orientation. Members of the LGBTQIA+ community are diverse in many ways such as race, ethnicity, nationality, religion, and class. There are so many overlapping aspects of an individual’s identity, which bring unique perspective and value to the therapeutic relationship.

Many of the LGBTQIA+ community are marginalized and face prejudice, discrimination, denial of human rights, harassment, and trauma. Many are not accepted not only by society at large but are not accepted and may be disowned by their family and loved ones. Many struggles with shame and experience a fractured relationship with their higher power which ultimately impacts mental health. Worsened mental health symptoms typically occur to other marginalized groups of people within this community, particularly people of color and/or low socioeconomic status.

Risk to the LGBTQIA+ Community

While being a member of the LGBTQIA+ community is something we sometimes see associated with pride parades and pride campaigns, it is not always something we and others feel is worth celebrating. It brings many unique challenges to mental health. LGB adults are twice as likely as heterosexual adults to experience a mental health condition.


Furthermore, our trans youth are twice as likely to experience depressive symptoms, seriously consider suicide, and attempt suicide compared to cisgender lesbian, gay, bisexual, queer, and questioning youth.

How Do I Find an affirming LGBTQIA+ Therapist?

Finding an affirming therapist to fit your needs is one of the most important steps to finding effective therapy. Oftentimes we are the most honest, willing, and ready to heal when in an environment where we feel safe, heard, and understood. It’s hard, to be honest, and let your guard down when you don’t feel comfortable! Especially when running the risk of prejudice and discrimination with professionals is unfortunately rather high.


Despite protections that have been put into place, the LGBTQIA+ community faces high rates of harassment, humiliation, and refusal of services from varying medical practitioners. In fact, research shows, up to 19% of people report avoiding healthcare and are discouraged from seeking the help that they need.

How to Choose the Right Therapist?

Important questions to ask are: is it important to me to find a therapist who identifies similarly to me? Or rather, is it important to find a therapist who is simply a member of the LGBTQIA+ community? Lastly, is it okay if my therapist is an ally and does not identify as being within the community? Is it important for my therapist to have specialized training?

If you are transgender and are seeking a mental health professional to write a letter of support for gender-affirming medical care or for legal documentation change, you should seek a provider who understands the insurance or legal requirements of support letters. This you can discuss with your insurance provider directly or can search google directly for something like “therapists for gender-affirming letters.” Additionally, you can click here to view a website filled with providers who do so for free or for a low cost.

Finding the Right Therapist for Me

Depending on the therapist, you may be able to find information indicating their identity on their profile or website. Some therapists may feel willing to disclose their identity, while others do not.

If you are on the website to a group practice, such as Bayview Therapy, it is great to toggle through the services offered and check to see that there is content on the website inclusive of YOUR identity (ie: